| NPI | 1649715509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PTT32231) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL3565) |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2017-01-03 |